A Study of Fibroid Vascularization and Vascular Indices With Three-Dimensional Power Doppler and Superb Microvascular Imaging and the Correlation With Heavy Menstrual Bleeding.

Autor:	Malik N; Obstetrics and Gynaecology, Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi, IND., Ranjan R; Radiology, Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi, IND., Khatri R; Obstetrics and Gynaecology, Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi, IND., Kumari S; Obstetrics and Gynaecology, Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi, IND., Malik V; Computer Science, University of Wisconsin-Madison, Madison, USA., Singh UK; Radiology, Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi, IND., Joon A; Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND., Madan N; Obstetrics and Gynaecology, ESIC (Employee's State Insurance Corporation) Hospital and Postgraduate Institute of Medical Sciences and Research (PGIMSR) Basaidarapur, New Delhi, IND., Khatuja R; Obstetrics and Gynaecology, Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi, IND., Singhal A; Obstetrics and Gynaecology, Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi, IND.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Oct 11; Vol. 16 (10), pp. e71246. Date of Electronic Publication: 2024 Oct 11 (Print Publication: 2024).
DOI:	10.7759/cureus.71246
Abstrakt:	Objective The objective of the study was to evaluate fibroid vascularization and vascular indices with three-dimensional (3D) power Doppler and superb microvascular imaging (SMI) and its correlation with heavy menstrual bleeding (HMB). Material and methods A total of 75 women with intramural uterine fibroid: 50 with HMB (Group A) and 25 without HMB (Group B) were recruited for the study. All participants were subjected to transabdominal and transvaginal color Doppler ultrasound. A 3D Power Doppler was used to measure Doppler Indices and flow rate in uterine arteries and the dominant vessel of fibroid. SMI was also used to determine vascularity in the dominant fibroid and to grade the vascularity. Results A significant association was observed between Doppler indices in the dominant feeding vessel of fibroid and HMB. Flow rates, namely peak systolic velocity (PSV) and end-diastolic velocity (EDV) were significantly higher. Contrarily, resistance measured as Resistive Index (RI) and Pulsatility Index (PI) was lower in Group A than in Group B. The mean PSV of the dominant feeding vessel in group A was 26.42 ± 4.57 and in group B was 14.56 ± 3.17, with p-value < 0.0001. For EDV, the median value (25th-75th percentile) in women with HMB was 6.76 (6.152-8.74) vs 3.99 (3.2-5.95) in women without HMB (p < 0.0001). A significant association was observed between uterine artery Doppler indices (specifically, PSV and EDV) and HMB. However, no significant association was found between RI and PI of the uterine artery and HMB. In the study of the vascular pattern on SMI, the percentage of women exhibiting both central and peripheral vascularity in Group A and Group B were 72% and 4%, respectively (p < 0.0001). Women in Group A showed a significantly higher proportion of grade 2 and grade 3 vascularity (76% and 20%, respectively), whereas only 4% showed grade 1 vascularity. Conversely, in Group B, all the women showed grade 1 vascularity (p <0.001). Conclusion Doppler indices in the dominant feeding vessel of fibroid show a positive correlation with HMB. In the study of the vascular pattern on SMI, a significant proportion of women with HMB exhibited both peripheral and central vascularity and a higher grade. Most women with symptomatic fibroids are of childbearing age and fertility preservation is at times their prime concern. Fibroid vascularization assessed with 3D power Doppler ultrasound and the new advanced SMU tool may prove to be useful in the prediction of response to various non-surgical management options of uterine leiomyoma and thus aid in counseling and appropriate patient selection. Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Committee & Scientific Research Committee, Dr. Baba Saheb Ambedkar Medical College and Hospital issued approval F.4(60)/2022/BSAH/DNB/PF - 2118. The study was reviewed by the Scientific Research Committee on March 13, 2023, March 18, 2023, and March 20, 2023, and by the Institutional Ethics Committee (IEC) on April 1, 2023. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Malik et al.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu